People with late-onset multiple sclerosis (MS) tend to more rapidly rise in disability scores than younger patients with early onset MS, according to study in MS patients in Kuwait that compared their scores during follow-up consultations.

Later onset disease can also be a diagnostic challenge, since its clinical presentation and course seems to be different from those with earlier onset MS. Few studies have traced the natural progression of late-onset disease.

Researchers at various universities and hospitals in Kuwait gathered demographic and clinical information on MS patients — presentation at onset, disease duration, number of relapses, and expanded disability status scale (EDSS) scores — using data from the Kuwait National MS Registry, established in 2010.

Their focus was time from baseline to sustained disability, defined by an EDSS score of 6.0. This score has been indirectly associated with disability progression, and is defined as the need for “intermittent or unilateral constant assistance [cane, crutch, or other] … to walk about 100 meters with or without resting.”

In total, the study included 99 (10.7%) late-onset patients with a median age of 45.9, and 804 (89.3%) early onset patients, whose median age was 26.6.

EDSS analysis during follow-up found that 19.2% of the late onset group and 15.7% of early onset patients reached EDSS 6.0. Late-onset MS patients reached this higher disability level much more quickly — a median of 6.5 years — than patients diagnosed with MS earlier in life, a group that took a median of 12.8 years to reach 6.0 on the EDSS scale. This difference, the researchers said, represented a 3.6-increased likelihood of late-onset patients reaching EDSS 6.0 compared to early onset patients.

Male gender and spinal symptoms at onset of MS were also significantly associated with increased risk, 1.85 and 1.47, respectively, of reaching EDSS 6.0 in a shorter time.

During this follow-up, a higher proportion of late-onset patients (26.3%) progressed to a more severe disease state — secondary progressive MS — compared to those with earlier onset (17.8%). Researchers also reported that spinal cord disease symptoms at onset were more prevalent among late-onset (46.5%) than early onset (32.3%) patients.

“LOMS [late-onset] patients attained EDSS 6.0 in a significantly shorter period that was influenced by male gender and spinal cord presentation at MS onset,” the researchers concluded, adding, “Since the prevalence of LOMS will continue to increase, there is a need to better understand the natural history of these patients and their response to earlier institution of treatment.”

9 comments

First time I have seen something that explains my situation I was 61 when I started to notice symptoms of MS and declined quickly to a wheelchair within a year. I have always been healthy and independent so learning to adapt has been a challenge to say the least.

Wow.Sorry that you have MS at such a late stage in life.One good thing about this is you got to live many years without having MS so just be a little thankful for this even know it sucks period.I haven’t meet anyone that’s very young with this stupid disease but I heard of young ones getting it and I feel for them.We all have to stay strong for each other no matter what age we get it and pray for a crue.????

Don´t believe in predictions that don´t empower you! Look at Betty Iams. I think health professionals try to break us by taking away our hope. Not much testing of the alternatives. I haven´t read a word about Terry Wahls here.
Why?

I was diagnosed at 49 due to a vision problem which turned out to be optic neuritis. A subsequent MRI proved my diagnosis to be MS. Within a year I was in a wheelchair. After a few months I went to a walker, then just a cane to unassisted now. I can’t run but… I’m 54 now, but I’m dealing with cognitive challenges. I was assessed by a neuropsychologist and did poorly on a test. I used to teach secondary Literature, but that became too much for me to manage.
Is this normal?

Unfortunately, MS does have many universal traits, but each individual reacts differently to them. We at MS News Today are sorry that you can not teach any more (which is a shame as Literature is such a fascinating study), but are encouraged that you are running a little. Stay active for as long as you can and enjoy each day. Normal is really what you make it to be in your reality.

I was diagnosed with PPMS in 2011 at age 58. The disease did progress fairly rapidly as was followed by my neurologist who specialized in MS. I have volunteered for studies and have participated in some with my strict intent to further research. Most studies or new meds, for example Ocremelzub (?)by Gennentech only is looking for people initially 55 or younger. This first drug to target PPMS. Why the age barrier, and second, wouldn’t I be a good candidate for trial ?

Thanks for the questions and comments Steve. We are not sure as to how the trials are set up (parameters, guidelines, etc) so it isn’t really right that we would comment about them. It is unfortunate, though, that you – being so close to the age – are not able to participate.

The symptoms described for LOMS is that of my 74 year old mother. I am so confused. We have been on a journey of discovering if she has dementia. It is a mystery. MRI shows normal atrophy and her patch has been increased to the second level, I believe 4.6 mg. I see little change and with most comments, the patch works to bring back a little concentration. She has little to zero improvement. My mother’s symptoms are muscle weakness, balance with walking, focusing (depth preception) and looks like she is shrinking away. Her mind is not great but it is not horrible. I have read and read about dementia (Lewy Body too) and it just doesnt add up. I am beyond frustrated. We have seen a neurologist that threw meds at her and now we are seeing her general dr with a better bedside manner. She doesnt have abnormal tremors. Slight but again, her hand(s) or head does not shake, etc. It is more of a weakness. Lastly, depression. It is out of the park. I believe her dr is afraid to add to her cocktail (which is not much at all). Lexapro, Wellbutrin, BP med, cholesteral med and a baby asprin. Any insight would be appreciated. Could it be possible that she has MS?

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